An 4-year-old neutered female indoor cat was referred for evaluation of a year-long history of chronic rhino-sinusitis with severe bloody mucopurulent discharges from the nose and eye with hysterical sneezing and itching was first noted 1.5 years previously

During the year prior to presentation, the cat had Previous treatment failures over 11 months including aggressive combinations of oral antibiotics (marbofloxacin, doxycycline, azithromycin), intranasal steroid, and ophthalmic corticosteroids therapy with systemic corticosteroids treatment

however the problem persisted and became more aggressive

Prior to the surgery head CT revealed an aggressive osteolytic lesion in the dorsal nasal bridge and left nasal cavity and extending into the frontal sinuses with a defect in the dorsal aspect of the maxilla causing fascial distortion and deformity

infection in the left nasal passage with extend to the frontal sinus with severe damage of the nasal turbinates rostrally and ventrally on the left side

Surgical decision was made for nasal and para nasal sinus trephination , debridement , bone curettage , lavage , soaking and fascial reconstruction using cytoflex titanium mesh and bone grafting with bio-film impregnated with antibiotics

Surgical decision was made for nasal and para nasal sinus trephination , debridement , bone curettage , lavage , soaking and fascial reconstruction using cytoflex titanium mesh and bone grafting with bio-film impregnated with antibiotics

The exposure provided through the surgical site allowed effective debridement of necrotic and inflamed material as far back as the frontal sinuses

Also an effective lavage and soaking with both antibiotics and antimycotics

The cat was discharged on amoxicillin–clavulanic acid (20 mg/kg) q12h pending culture results

Culture and cytology results came up with positive gram negative bacterial infection with negative fungal culture and treated accordingly